Usefulness of lateral-anteroposterior dimeter ratio in patients with tracheomalacia associated with esophageal atresia
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In brief
In brief
This study evaluates the lateral-to-anteroposterior diameter ratio (LAR) as a quantitative measure of tracheomalacia severity in esophageal atresia patients. Posterior tracheopexy significantly reduced LAR from 2.26 to 1.50, and patients achieving improved LAR avoided additional airway interventions, suggesting LAR is a useful prognostic indicator for surgical outcomes.
- Lateral-to-anteroposterior diameter ratio (LAR) is a useful quantitative index for assessing tracheomalacia severity in EA patients.
- Posterior tracheopexy significantly reduced median LAR from 2.26 to 1.50, indicating improved tracheal geometry.
- Patients achieving LAR normalization with posterior tracheopexy did not require additional surgical intervention for tracheomalacia.
- Persistent elevated LAR post-tracheopexy (>2.0) may predict need for further intervention such as external tracheal stenting.
Written by the GCMD Library team from the article.
Abstract
Purpose
Tracheomalacia (TM) is commonly associated with esophageal atresia (EA) and compression by the brachiocephalic artery is a factor for TM. Previous research has focused on the lateral-to-anteroposterior tracheal diameter ratio (LAR). This study aimed to assess the LAR and postoperative outcomes of EA patients.
Methods
Patients undergoing thoracoscopic repair for EA between March 2020 and October 2023 were enrolled. Posterior tracheopexy (PT) was performed during thoracoscopic repair of EA on patients with bronchoscopy-confirmed TM; clinical courses and LAR were retrospectively analyzed.
Results
Overall, 18 patients were enrolled; 14 patients underwent PT. Their median preoperative and postoperative LARs were 2.26 and 1.50, respectively; this difference was statistically significant. Four patients without TM did not undergo PT and their median LAR was 1.59. Median LAR for patients without PT was lower than that of preoperative patients with PT and no statistical differences were observed from that of postoperative patients with PT. The patients whose LAR improved with PT did not require further surgical intervention for TM. One patient who had a postoperative LAR of 2.25 required external tracheal stenting.
Conclusion
LAR is a useful index for determining the severity of TM associated with EA. LAR can reflects the efficacy of PT.